Offices and Clinics of Doctors of Osteopathy

SIC 8031

Industry report:

This industry consists of offices and clinics of licensed doctors of osteopathic medicine (DOs) and engaged in the practice of general or specialized osteopathic medicine and surgery. Establishments operating as clinics of osteopathic physicians are included in this industry. Like medical doctors, doctors of osteopathic medicine are complete physicians with at least four years of medical school training, but they differ from medical doctors by focusing on structural derangement, especially that of the spinal cord, as the chief cause of disease.

According to the American Osteopathic Association (AOA), there were 78,000 doctors of osteopathy in the United States in 2012, accounting for about 6 percent of all physicians nationwide. Of these doctors, approximately 65 percent practice in the primary care fields. Although DOs represent just 7 percent of all physicians, they account for 15 percent of all physicians practicing in rural areas with populations of 2,500 or less. Their fields of specialty include surgery, obstetrics and gynecology, pediatrics, psychiatry, neurology, and internal medicine.

This branch of medicine has grown considerably since 1970, when there were just over 14,300 DOs practicing in the United States. Ten years later, that number had jumped to 18,800, and by 1990 the number of practicing osteopathic doctors had climbed to 30,000, with only 2 percent working in hospitals and another 2 percent teaching. By 2001 the total number of DOs had grown to 47,000. It is estimated that at least 100,000 osteopathic physicians will be in active medical practice by 2020. The AOA estimates that DOs receive some 100 million patient visits annually. The greatest future demand for DOs will be in rural and suburban areas. Employment is expected to grow faster than average, with the best prospects being in primary care fields such as family practice, geriatrics, and preventive care.

There are 26 colleges of osteopathic medicine in 28 locations in the United States. Twenty are private and six are public. There has been a continued steady increase in the number of students pursuing studies in osteopathic medicine, according to the AOA. The number of students enrolled in osteopathic colleges in 2004-2005 was 12,600. By the 2008-2009 school year, that number had growth to 16,893. In addition, the number of DO graduates more than tripled from 1,032 in 1980 to 3,364 in 2008. In 2011 enrollment in osteopathic colleges totaled 19,427, and more than 20 percent of all first-year medical students were attending a college of osteopathic medicine. Osteopathic postdoctoral training programs have experienced similar increases. Although the number of DOs in the United States increased significantly, so did the number of MDs, and the percentage of patients seen by DOs relative to MDs remained relatively constant around 7 percent annually (ranging from 6 to 8 percent from 2000-2009).

In 2009 approximately 31 percent of all active DOs and 49 percent of all DO students in the United States were women. Although the percentage of African-American and Hispanic DOs remained relatively level during the first decade of the 2000s, the percentage of Asians choosing to enter osteopathic medicine increased. Nevertheless, the majority of DOs (70 percent) were white at the end of the decade.

At the end of the first decade of the 2000s, the six states with the most practicing DOs were New York, Ohio, California, Florida, Michigan, and Pennsylvania. The 10 states in which DOs comprised at least 10 percent of all practicing physicians were Oklahoma (19.3 percent), Michigan (17.4 percent), Iowa (15.8 percent), Maine (14 percent), West Virginia (13.2 percent), Pennsylvania (13 percent), Missouri (12 percent), Ohio (11.1 percent), and Arizona (10.8 percent).

Overseas, U.S. DOs have operated clinics and trained staff, but typically have not set up private practices for themselves, as salaries are not as high as those in the United States. The United States is the only country in the world that has osteopathic medicine integrated with a physician's degree. In other countries, practitioners generally earn certification after one to two years of schooling and hold less prestige than their U.S. counterparts.

Although the number of DOs involved in primary care had been gradually decreasing for several decades, reaching a record low of 40.9 percent in 2009, this sector posted a 16 percent increase in 2011. At the same time, the number of DOs pursuing specialties was steadily increasing. The most populated specialties included general internal medicine (10 percent), pediatrics (4.7 percent), obstetrics (4.3 percent), and osteopathic manipulative medicine (1.8 percent). Overall, the AOA approved 72 different specialties, subspecialties, and areas of added qualifications for which DOs could apply for certification. In 2009 there were 22,395 DOs who were certified in at least one specialty by one of the 18 AOA-approved certification boards. Like their MD counterparts, graduating DOs were finding it difficult at the end of the first decade of the 2000s to reconcile up to $200,000 of school loan debts with the lower paying career path of primary care. Therefore, even while expressing a desire for a family practice, many were opting to pursue a more lucrative position in specialty medicine.

According to IBISWorld, the osteopathic medicine industry was worth approximately $13 billion in 2011 and was expected to increase at an annual rate of less than 1 percent annually through 2017. The aging U.S. population, as well as the increased acceptance of nontraditional medical practices, boded well for the industry into the 2010s.

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